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Cytomegalovirus cholangitis presenting with recurrent hemobilia.
I M Tleyjeh1, G Georgescu, A Virk
1Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. Tleyjeh.imad@mayo.edu
Summary
Cytomegalovirus (CMV) cholangitis, a rare CMV infection complication, occurred in a patient on corticosteroids. Successful treatment involved ganciclovir and cholecystostomy, marking a novel case presentation.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Cytomegalovirus (CMV) cholangitis is a rare complication of CMV infection.
- Previously, it has been documented exclusively in immunocompromised individuals, such as those with HIV or solid-organ transplants.
Observation:
- This report details a unique case of CMV cholangitis in a patient undergoing long-term corticosteroid therapy.
- The patient presented with recurrent hemobilia and biliary obstruction, symptoms indicative of severe biliary compromise.
Findings:
- The patient was successfully treated with ganciclovir, an antiviral medication, and cholecystostomy, a surgical procedure to drain the gallbladder.
- This case represents the first documented instance of CMV cholangitis in a patient solely on chronic corticosteroid therapy.
Implications:
- This case expands the known spectrum of patients susceptible to CMV cholangitis beyond traditionally immunocompromised groups.
- It highlights the importance of considering CMV infection in patients on immunosuppressive therapy presenting with unexplained biliary issues.
- The successful treatment underscores the efficacy of ganciclovir and supportive measures like cholecystostomy in managing this rare condition.